Tennis Elbow Tests: How to Check for Lateral Epicondylitis

The primary special tests for Lateral Epicondylitis, or "Tennis Elbow," are Cozen's Test and Mill's Test. These tests are used by physiotherapists to provoke pain at the lateral epicondyle by stressing the common extensor tendon.

1. Purpose

The primary purpose of these tests is to **test for** Lateral Epicondylitis (Tennis Elbow). Both tests (Cozen's and Mill's) are designed to stress the common extensor tendon at the lateral epicondyle, particularly the Extensor Carpi Radialis Brevis (ECRB) tendon, to reproduce the patient's pain.

2. How to Perform

The patient is typically positioned in sitting with their elbow stabilized.

Cozen's Test (Resisted Test)

1. The examiner stabilizes the patient's elbow, palpating the lateral epicondyle.
2. The patient's forearm is pronated, and they make a fist.
3. The patient actively extends and radially deviates their wrist.
4. The examiner applies a strong resistance to this movement.

Mill's Test (Passive Stretch)

1. The examiner stabilizes the patient's elbow, palpating the lateral epicondyle.
2. The examiner passively pronates the patient's forearm.
3. The examiner passively flexes the patient's wrist.
4. While holding wrist flexion, the examiner slowly extends the patient's elbow fully.

3. Positive & Negative Sign

Positive Sign (Test is POSITIVE):
A positive test (indicating Lateral Epicondylitis) is:

• Reproduction of the patient's familiar, sharp pain over the lateral epicondyle.

Negative Sign (Test is NEGATIVE):
A negative test is the absence of pain at the lateral epicondyle during the maneuvers.